The ROMS system will help healthcare providers to offer high quality, cost-effective, evidence-based care for SPMI and dually diagnosed consumers. Specifically, ROMS will provide: In depth treatment planning: ROMS will provide clinicians with reliable information on consumer strengths, functioning and symptomology as well as critical "signs" or "behaviors" requiring immediate attention at the beginning of treatment. Treatment management: Based on consumer responses over time, clinicians will evaluate a consumer' s progress in relation to a predicted course and level of risk for hospitalization, so that treatment strategies can be altered as necessary to avoid adverse outcomes. Continual refinement of its ability to evaluate "what works for whom" as its database of consumer strengths, symptoms, behaviors and risk factors grows, creating the first "learning system" for the treatment of SPMI consumers. ROMS is designed for easy integration into office practices, and offers numerous features to overcome obstacles to reliable self-report by SPMI consumers. Consumers and their caregivers complete questionnaires using a PC, or handheld device (e.g., PDA). Reports indicating the consumer's condition and progress are immediately available to clinicians. Clinician ratings relating to level of care and clinical risk/severity are displayed on a separate report, suitable for clinical case documentation and use by case managers. Phase II research includes the collection of longitudinal data from 300 SPMI consumers. Hierarchical linear modeling will be used with this dataset to develop algorithms for the prediction of treatment response and risk for hospitalization. [unreadable] [unreadable]